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        If you use plots from MultiQC in a publication or presentation, please cite:

        MultiQC: Summarize analysis results for multiple tools and samples in a single report
        Philip Ewels, Måns Magnusson, Sverker Lundin and Max Käller
        Bioinformatics (2016)
        doi: 10.1093/bioinformatics/btw354
        PMID: 27312411
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        About HyRISE

        This report was generated using HyRISE v0.2.2 (HIV Resistance Interpretation & Scoring Engine).

        HyRISE analyzes HIV drug resistance mutations and presents interactive visualizations with clinically oriented interpretation to support treatment planning.

        HyRISE is built using the MultiQC framework (Ewels P, et al. MultiQC: Summarize analysis results for multiple tools and samples in a single report. Bioinformatics. 2016;32(19):3047-8).

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        HyRISE: Resistance Interpretation & Scoring Engine
        HIV Drug Resistance Sequencing Analysis Report

        Interpretation of HIV drug resistance mutations derived from sequencing data. This report combines Sierra-Local outputs with HyRISE visualizations to summarize resistance patterns, mutation profiles, and potential treatment impact.
        Sample Name
        DEMO_COMBO_NGS
        Analysis Date
        2026-02-19 10:29:41
        Genes Analyzed
        IN, PR, RT
        Stanford DB Version
        10.1
        Stanford DB Date
        2026-01-18
        IN Mut / SDRM
        9 / 1
        PR Mut / SDRM
        27 / 4
        RT Mut / SDRM
        32 / 8
        HyRISE Version
        0.2.2
        Report generated on 2026-02-19, 10:29 CST

        IN Mutation Position Map

        Interactive visualization of mutations along the IN gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.

        Interactive map of integrase mutation positions with functional-domain context and position-level details.

        IN Mutation Position Map

        This visualization shows 9 mutations detected in the IN gene (positions 1-289), including 1 major resistance mutations and 1 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.

        1-100
         
         
         
         
         
         
         
         
         
        10Position 10
        • E10D - Other
          Changed from E to D
         
         
         
         
         
         
         
         
         
        20
         
         
         
         
         
         
         
         
         
        30
         
         
         
         
         
         
         
         
         
        40
         
         
         
         
         
         
         
         
         
        50
         
         
         
         
         
         
         
         
         
        60
         
         
         
         
         
         
         
         
         
        70
         
        72Position 72
        • I72V - Other
          Changed from I to V
         
        74Position 74
        • L74M - Accessory
          Changed from L to M
         
         
         
         
         
        80
         
         
         
         
         
         
         
         
         
        90
         
         
         
         
         
         
         
         
         
        100
        101-200
         
         
         
         
         
         
         
         
         
        110
         
         
         
         
         
         
         
         
         
        120
        121Position 121
        • F121Y - Major (SDRM)
          Changed from F to Y
         
         
        124Position 124
        • T124A - Other
          Changed from T to A
         
         
         
         
         
        130
         
         
         
         
         
         
         
         
         
        140
         
         
         
         
         
         
         
         
         
        150
        151Position 151
        • V151I - Other
          Changed from V to I
         
         
         
         
         
         
         
         
        160
         
         
        163Position 163
        • G163R - Accessory
          Changed from G to R
         
         
         
         
         
         
        170
         
         
         
         
         
         
         
         
         
        180
         
         
         
         
         
         
         
         
         
        190
         
         
         
         
         
         
         
         
         
        200
        201-289
         
         
         
         
         
         
         
         
         
        210
         
         
         
         
         
         
         
         
         
        220
         
         
         
         
         
         
         
         
         
        230
         
        232Position 232
        • D232N - Accessory
          Changed from D to N
         
         
         
         
         
         
         
        240
         
         
         
         
         
         
         
         
         
        250
         
         
         
         
         
        256Position 256
        • D256ND - Other (APOBEC)
          Changed from D to DN
         
         
         
        260
         
         
         
         
         
         
         
         
         
        270
         
         
         
         
         
         
         
         
         
        280
         
         
         
         
         
         
         
         
         
        Major Mutation (Directly confers resistance)
        Accessory Mutation (Enhances resistance)
        Other Mutation (Polymorphism or unknown effect)
        Surveillance Drug Resistance Mutation (SDRM)
        APOBEC-mediated mutation

        Mutation Distribution Summary

        Mutation TypeCountPercentage
        Major Mutations111.1%
        Accessory Mutations333.3%
        Other Mutations555.6%
        SDRM Mutations111.1%
        APOBEC-Mediated Mutations111.1%
        Total Mutations9100.0%

        IN Mutation-Specific Resistance Contribution

        Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in IN, highlighting the relative impact of specific mutations on drug efficacy.

        Per-mutation contribution of integrase variants to INSTI resistance scores, including primary and accessory pathways.

        Showing 16/16 rows and 10/12 columns.
        DrugDrugClassDrug PriorityMutationsTypeSDRMContributionWeightedTotal Score% of TotalImpact CategoryClinical Comment
        BIC_F121Y
        BIC
        INSTI
        5
        F121Y
        MajorNo
        10
        16.7
        15
        66.7%
        Major
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        BIC_L74M
        BIC
        INSTI
        5
        L74M
        OtherNo
        5
        8.3
        15
        33.3%
        Significant (High-Priority Drug)
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        CAB_F121Y
        CAB
        INSTI
        3
        F121Y
        MajorNo
        15
        15.0
        20
        75.0%
        Dominant
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        CAB_L74M
        CAB
        INSTI
        3
        L74M
        OtherNo
        5
        5.0
        20
        25.0%
        Significant
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        DTG_F121Y
        DTG
        INSTI
        5
        F121Y
        MajorNo
        10
        16.7
        15
        66.7%
        Major
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        DTG_L74M
        DTG
        INSTI
        5
        L74M
        OtherNo
        5
        8.3
        15
        33.3%
        Significant (High-Priority Drug)
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        EVG_D232N
        EVG
        INSTI
        3
        D232N
        OtherNo
        10
        10.0
        95
        10.5%
        Minor
        D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility.
        EVG_F121Y
        EVG
        INSTI
        3
        F121Y
        MajorNo
        60
        60.0
        95
        63.2%
        Major
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        EVG_G163R
        EVG
        INSTI
        3
        G163R
        AccessoryNo
        15
        15.0
        95
        15.8%
        Minor
        G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized.
        EVG_L74M
        EVG
        INSTI
        3
        L74M
        OtherNo
        5
        5.0
        95
        5.3%
        Minor
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        EVG_V151I
        EVG
        INSTI
        3
        V151I
        OtherNo
        5
        5.0
        95
        5.3%
        Minor
        V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs.
        RAL_D232N
        RAL
        INSTI
        3
        D232N
        OtherNo
        10
        10.0
        95
        10.5%
        Minor
        D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility.
        RAL_F121Y
        RAL
        INSTI
        3
        F121Y
        MajorNo
        60
        60.0
        95
        63.2%
        Major
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        RAL_G163R
        RAL
        INSTI
        3
        G163R
        AccessoryNo
        15
        15.0
        95
        15.8%
        Minor
        G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized.
        RAL_L74M
        RAL
        INSTI
        3
        L74M
        OtherNo
        5
        5.0
        95
        5.3%
        Minor
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        RAL_V151I
        RAL
        INSTI
        3
        V151I
        OtherNo
        5
        5.0
        95
        5.3%
        Minor
        V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs.

        IN Mutations

        Comprehensive listing of all mutations detected in the IN gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.

        Filterable catalog of integrase mutations with positions, resistance attributes, and special labels.

        Showing 9/9 rows and 7/7 columns.
        MutationMutationPositionTypeSDRMAPOBECUnusualStructure
        DEMO_COMBO_NGS_D232N
        D232N
        232
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_D256ND
        D256ND
        256
        OtherNoYesNoSubstitution
        DEMO_COMBO_NGS_E10D
        E10D
        10
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_F121Y
        F121Y
        121
        MajorYesNoNoSubstitution
        DEMO_COMBO_NGS_G163R
        G163R
        163
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_I72V
        I72V
        72
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L74M
        L74M
        74
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_T124A
        T124A
        124
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V151I
        V151I
        151
        OtherNoNoNoSubstitution

        IN Mutation Summary

        Summary of mutation types detected in the IN gene, including counts, percentages, and complete lists of mutations by type.

        Distribution of integrase mutation types by clinical relevance, including major pathway and accessory mutations.

        Showing 5/5 rows and 4/4 columns.
        Mutation TypeCountPercentageMutationsClinical Implication
        Major
        1
        11.1%
        F121YDirect resistance to one or more drugs
        Accessory
        3
        33.3%
        D232N, G163R, L74MEnhance resistance when present with major mutations
        SDRM
        1
        11.1%
        F121YUsed for surveillance of transmitted resistance
        APOBEC
        1
        11.1%
        D256NDArtifacts of APOBEC-mediated hypermutation
        Other
        5
        55.6%
        D256ND, E10D, I72V, T124A, V151IPolymorphisms or mutations with minimal impact on drug resistance

        IN Mutation Clinical Significance

        Consolidated analysis of IN mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.

        Clinical interpretation of integrase mutations, covering effects on target binding, enzyme function, and resistance pathways.

        Showing 5/5 rows and 6/7 columns.
        Mutation TypeTypeMutationSDRMAPOBECAffected DrugsMax ImpactClinical Implication
        Accessory_G163RAccessoryG163RNoNoEVG (INSTI) (15.0), RAL (INSTI) (15.0)
        15
        G163R/K are nonpolymorphic in all subtypes except subtype F. They have been selected primarily in persons receiving RAL and less commonly in persons receiving DTG. They appear to be accessory mutations as they typically occur in combination with other INSTI-resistance mutations. Their phenotypic effects have not been well characterized.
        INSTI_D232NINSTID232NNoNoEVG (INSTI) (10.0), RAL (INSTI) (10.0)
        10
        D232N is a common nonpolymorphic accessory mutation selected in persons receiving RAL and EVG. Alone, it has little effect on INSTI susceptibility.
        Major_F121YMajorF121YYesNoEVG (INSTI) (60.0), RAL (INSTI) (60.0), CAB (INSTI) (15.0), BIC (INSTI) (10.0), DTG (INSTI) (10.0)
        60
        F121Y is a rare nonpolymorphic mutation selected primarily by RAL. It is associated with >10-fold reduced susceptibility to RAL but has minimal if any effect on susceptibility to CAB, DTG, and BIC.
        Other_L74MOtherL74MNoNoBIC (INSTI) (5.0), CAB (INSTI) (5.0), DTG (INSTI) (5.0), EVG (INSTI) (5.0), RAL (INSTI) (5.0)
        5
        L74M is a common polymorphic INSTI-resistance mutation. It has a prevalence between 1% and 5% among INSTI-naïve persons depending on subtype. It appears to be selected by each of the INSTIs. Alone it does not reduce INSTI susceptibility. However, in combination with other INSTI-resistance mutations, it contributes reduced susceptibility to each of the INSTIs.
        Other_V151IOtherV151INoNoEVG (INSTI) (5.0), RAL (INSTI) (5.0)
        5
        V151I is an accessory INSTI selected mutation that occurs in 1% to 3% of viruses from ART-naïve persons depending on subtype. Alone, it appears to have little or no effect on INSTI susceptibility but may contribute to reduced INSTI susceptibility in combination with other DRMs.

        IN Drug Resistance Profile

        Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for IN gene.

        Drug-level INSTI resistance profile with quantitative scoring, interpretation, and clinically weighted comparison.

        Showing 5/5 rows and 5/8 columns.
        DrugDrugClassScoreWeighted ScorePrioritySIRLevelInterpretation
        DEMO_COMBO_NGS_BIC
        BIC
        INSTI
        15
        25.0
        5
        I
        3
        Low-Level Resistance
        DEMO_COMBO_NGS_CAB
        CAB
        INSTI
        20
        20.0
        3
        I
        3
        Low-Level Resistance
        DEMO_COMBO_NGS_DTG
        DTG
        INSTI
        15
        25.0
        5
        I
        3
        Low-Level Resistance
        DEMO_COMBO_NGS_EVG
        EVG
        INSTI
        95
        95.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_RAL
        RAL
        INSTI
        95
        95.0
        3
        R
        5
        High-Level Resistance

        IN Drug Class Overview

        Summary of drug resistance patterns by drug class for IN. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 2 high-priority drugs affected.

        Summary of integrase inhibitor resistance across first-generation (RAL, EVG) and second-generation (DTG, BIC, CAB) INSTIs.

        Showing 1/1 rows and 13/13 columns.
        Drug ClassDrug ClassTotal DrugsResistant% ResistantWeighted ScoreHigh-PriorityMax ScoreStatusHighIntLowPotSus
        IN_INSTI
        INSTI
        5
        5
        100.0%
        52.0
        2
        95
        High-level resistance
        2
        0
        3
        0
        0

        PR Mutation Position Map

        Interactive visualization of mutations along the PR gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.

        Interactive map of protease mutation positions across the gene, with type-based coloring, SDRM highlighting, and per-position tooltips.

        PR Mutation Position Map

        This visualization shows 27 mutations detected in the PR gene (positions 1-99), including 3 major resistance mutations and 4 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.

        1-99
         
         
         
         
         
         
         
         
         
        10Position 10
        • L10R - Other
          Changed from L to R
        11Position 11
        • V11L - Other
          Changed from V to L
         
        13Position 13
        • I13V - Other
          Changed from I to V
         
        15Position 15
        • I15V - Other
          Changed from I to V
         
         
         
        19Position 19
        • L19I - Other
          Changed from L to I
        20Position 20
        • K20T - Accessory
          Changed from K to T
         
         
         
         
         
         
         
         
         
        30
         
        32Position 32
        • V32I - Major (SDRM)
          Changed from V to I
        33Position 33
        • L33F - Accessory
          Changed from L to F
         
        35Position 35
        • E35G - Other
          Changed from E to G
        36Position 36
        • M36I - Other
          Changed from M to I
        37Position 37
        • N37T - Other
          Changed from N to T
         
        39Position 39
        • P39PS - Other
          Changed from P to PS
        40
        41Position 41
        • R41K - Other
          Changed from R to K
         
         
         
         
         
        47Position 47
        • I47V - Major (SDRM)
          Changed from I to V
         
         
        50
         
         
         
         
         
         
         
        58Position 58
        • Q58E - Accessory
          Changed from Q to E
         
        60Position 60
        • D60E - Other
          Changed from D to E
         
        62Position 62
        • I62V - Other
          Changed from I to V
        63Position 63
        • L63P - Other
          Changed from L to P
         
         
         
         
         
         
        70Position 70
        • K70E - Other
          Changed from K to E
        71Position 71
        • A71V - Other
          Changed from A to V
         
        73Position 73
        • G73S - Accessory (SDRM)
          Changed from G to S
         
         
         
        77Position 77
        • V77I - Other
          Changed from V to I
         
         
        80
         
        82Position 82
        • V82I - Other
          Changed from V to I
         
         
         
         
         
         
        89Position 89
        • L89V - Accessory
          Changed from L to V
        90Position 90
        • L90M - Major (SDRM)
          Changed from L to M
         
         
        93Position 93
        • I93L - Other
          Changed from I to L
         
        95Position 95
        • C95V - Other
          Changed from C to V
         
         
         
         
        Major Mutation (Directly confers resistance)
        Accessory Mutation (Enhances resistance)
        Other Mutation (Polymorphism or unknown effect)
        Surveillance Drug Resistance Mutation (SDRM)
        APOBEC-mediated mutation

        Mutation Distribution Summary

        Mutation TypeCountPercentage
        Major Mutations311.1%
        Accessory Mutations518.5%
        Other Mutations1970.4%
        SDRM Mutations414.8%
        Total Mutations27100.0%

        PR Mutation-Specific Resistance Contribution

        Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in PR, highlighting the relative impact of specific mutations on drug efficacy.

        Per-mutation contribution of protease variants to resistance scores for each PI, highlighting dominant resistance drivers.

        Showing 66/66 rows and 10/12 columns.
        DrugDrugClassDrug PriorityMutationsTypeSDRMContributionWeightedTotal Score% of TotalImpact CategoryClinical Comment
        ATV_r_G73S
        ATV/r
        PI
        3
        G73S
        AccessoryNo
        10
        10.0
        80
        12.5%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        ATV_r_G73S_+_L90M
        ATV/r
        PI
        3
        G73S + L90M
        MajorNo
        10
        10.0
        80
        12.5%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        ATV_r_I47V
        ATV/r
        PI
        3
        I47V
        MajorNo
        10
        10.0
        80
        12.5%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        ATV_r_K20T
        ATV/r
        PI
        3
        K20T
        AccessoryNo
        5
        5.0
        80
        6.2%
        Minor
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        ATV_r_L33F
        ATV/r
        PI
        3
        L33F
        AccessoryNo
        5
        5.0
        80
        6.2%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        ATV_r_L90M
        ATV/r
        PI
        3
        L90M
        MajorNo
        20
        20.0
        80
        25.0%
        Significant
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        ATV_r_V32I
        ATV/r
        PI
        3
        V32I
        MajorNo
        15
        15.0
        80
        18.8%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        ATV_r_V32I_+_I47V
        ATV/r
        PI
        3
        V32I + I47V
        MajorNo
        5
        5.0
        80
        6.2%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        DRV_r_I47V
        DRV/r
        PI
        5
        I47V
        MajorNo
        10
        16.7
        50
        20.0%
        Minor (High-Priority Drug)
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        DRV_r_L33F
        DRV/r
        PI
        5
        L33F
        AccessoryNo
        5
        8.3
        50
        10.0%
        Minor (High-Priority Drug)
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        DRV_r_L89V
        DRV/r
        PI
        5
        L89V
        AccessoryNo
        5
        8.3
        50
        10.0%
        Minor (High-Priority Drug)
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        DRV_r_V11L_+_V32I
        DRV/r
        PI
        5
        V11L + V32I
        MajorNo
        5
        8.3
        50
        10.0%
        Minor (High-Priority Drug)
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        DRV_r_V32I
        DRV/r
        PI
        5
        V32I
        MajorNo
        15
        25.0
        50
        30.0%
        Significant (High-Priority Drug)
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        DRV_r_V32I_+_I47V
        DRV/r
        PI
        5
        V32I + I47V
        MajorNo
        5
        8.3
        50
        10.0%
        Minor (High-Priority Drug)
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        DRV_r_V32I_+_L89V
        DRV/r
        PI
        5
        V32I + L89V
        MajorNo
        5
        8.3
        50
        10.0%
        Minor (High-Priority Drug)
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        FPV_r_G73S
        FPV/r
        PI
        3
        G73S
        AccessoryNo
        10
        10.0
        145
        6.9%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        FPV_r_G73S_+_L90M
        FPV/r
        PI
        3
        G73S + L90M
        MajorNo
        10
        10.0
        145
        6.9%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        FPV_r_I47V
        FPV/r
        PI
        3
        I47V
        MajorNo
        35
        35.0
        145
        24.1%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        FPV_r_K20T
        FPV/r
        PI
        3
        K20T
        AccessoryNo
        5
        5.0
        145
        3.4%
        Minor
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        FPV_r_L33F
        FPV/r
        PI
        3
        L33F
        AccessoryNo
        10
        10.0
        145
        6.9%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        FPV_r_L89V
        FPV/r
        PI
        3
        L89V
        AccessoryNo
        10
        10.0
        145
        6.9%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        FPV_r_L90M
        FPV/r
        PI
        3
        L90M
        MajorNo
        20
        20.0
        145
        13.8%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        FPV_r_V11L_+_V32I
        FPV/r
        PI
        3
        V11L + V32I
        MajorNo
        5
        5.0
        145
        3.4%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        FPV_r_V32I
        FPV/r
        PI
        3
        V32I
        MajorNo
        30
        30.0
        145
        20.7%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        FPV_r_V32I_+_I47V
        FPV/r
        PI
        3
        V32I + I47V
        MajorNo
        5
        5.0
        145
        3.4%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        FPV_r_V32I_+_L89V
        FPV/r
        PI
        3
        V32I + L89V
        MajorNo
        5
        5.0
        145
        3.4%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        IDV_r_G73S
        IDV/r
        PI
        3
        G73S
        AccessoryNo
        15
        15.0
        115
        13.0%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        IDV_r_G73S_+_L90M
        IDV/r
        PI
        3
        G73S + L90M
        MajorNo
        10
        10.0
        115
        8.7%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        IDV_r_I47V
        IDV/r
        PI
        3
        I47V
        MajorNo
        15
        15.0
        115
        13.0%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        IDV_r_K20T
        IDV/r
        PI
        3
        K20T
        AccessoryNo
        5
        5.0
        115
        4.3%
        Minor
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        IDV_r_L33F
        IDV/r
        PI
        3
        L33F
        AccessoryNo
        5
        5.0
        115
        4.3%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        IDV_r_L89V
        IDV/r
        PI
        3
        L89V
        AccessoryNo
        5
        5.0
        115
        4.3%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        IDV_r_L90M
        IDV/r
        PI
        3
        L90M
        MajorNo
        30
        30.0
        115
        26.1%
        Significant
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        IDV_r_V11L_+_V32I
        IDV/r
        PI
        3
        V11L + V32I
        MajorNo
        5
        5.0
        115
        4.3%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        IDV_r_V32I
        IDV/r
        PI
        3
        V32I
        MajorNo
        15
        15.0
        115
        13.0%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        IDV_r_V32I_+_I47V
        IDV/r
        PI
        3
        V32I + I47V
        MajorNo
        5
        5.0
        115
        4.3%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        IDV_r_V32I_+_L89V
        IDV/r
        PI
        3
        V32I + L89V
        MajorNo
        5
        5.0
        115
        4.3%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        LPV_r_G73S
        LPV/r
        PI
        3
        G73S
        AccessoryNo
        5
        5.0
        65
        7.7%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        LPV_r_I47V
        LPV/r
        PI
        3
        I47V
        MajorNo
        15
        15.0
        65
        23.1%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        LPV_r_L33F
        LPV/r
        PI
        3
        L33F
        AccessoryNo
        5
        5.0
        65
        7.7%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        LPV_r_L90M
        LPV/r
        PI
        3
        L90M
        MajorNo
        10
        10.0
        65
        15.4%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        LPV_r_V11L_+_V32I
        LPV/r
        PI
        3
        V11L + V32I
        MajorNo
        5
        5.0
        65
        7.7%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        LPV_r_V32I
        LPV/r
        PI
        3
        V32I
        MajorNo
        15
        15.0
        65
        23.1%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        LPV_r_V32I_+_I47V
        LPV/r
        PI
        3
        V32I + I47V
        MajorNo
        5
        5.0
        65
        7.7%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        LPV_r_V32I_+_L89V
        LPV/r
        PI
        3
        V32I + L89V
        MajorNo
        5
        5.0
        65
        7.7%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        NFV_G73S
        NFV
        PI
        3
        G73S
        AccessoryNo
        15
        15.0
        180
        8.3%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        NFV_G73S_+_L90M
        NFV
        PI
        3
        G73S + L90M
        MajorNo
        10
        10.0
        180
        5.6%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        NFV_I47V
        NFV
        PI
        3
        I47V
        MajorNo
        20
        20.0
        180
        11.1%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        NFV_K20T
        NFV
        PI
        3
        K20T
        AccessoryNo
        15
        15.0
        180
        8.3%
        Minor
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        NFV_L33F
        NFV
        PI
        3
        L33F
        AccessoryNo
        10
        10.0
        180
        5.6%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        NFV_L89V
        NFV
        PI
        3
        L89V
        AccessoryNo
        10
        10.0
        180
        5.6%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        NFV_L90M
        NFV
        PI
        3
        L90M
        MajorNo
        60
        60.0
        180
        33.3%
        Significant
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        NFV_Q58E
        NFV
        PI
        3
        Q58E
        AccessoryNo
        10
        10.0
        180
        5.6%
        Minor
        Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance.
        NFV_V11L_+_V32I
        NFV
        PI
        3
        V11L + V32I
        MajorNo
        5
        5.0
        180
        2.8%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        NFV_V32I
        NFV
        PI
        3
        V32I
        MajorNo
        15
        15.0
        180
        8.3%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        NFV_V32I_+_I47V
        NFV
        PI
        3
        V32I + I47V
        MajorNo
        5
        5.0
        180
        2.8%
        Minor
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        NFV_V32I_+_L89V
        NFV
        PI
        3
        V32I + L89V
        MajorNo
        5
        5.0
        180
        2.8%
        Minor
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        SQV_r_G73S
        SQV/r
        PI
        3
        G73S
        AccessoryNo
        15
        15.0
        80
        18.8%
        Minor
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        SQV_r_G73S_+_L90M
        SQV/r
        PI
        3
        G73S + L90M
        MajorNo
        10
        10.0
        80
        12.5%
        Minor
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        SQV_r_K20T
        SQV/r
        PI
        3
        K20T
        AccessoryNo
        5
        5.0
        80
        6.2%
        Minor
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        SQV_r_L33F
        SQV/r
        PI
        3
        L33F
        AccessoryNo
        5
        5.0
        80
        6.2%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        SQV_r_L90M
        SQV/r
        PI
        3
        L90M
        MajorNo
        45
        45.0
        80
        56.2%
        Major
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        TPV_r_I47V
        TPV/r
        PI
        3
        I47V
        MajorNo
        30
        30.0
        60
        50.0%
        Major
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        TPV_r_L33F
        TPV/r
        PI
        3
        L33F
        AccessoryNo
        10
        10.0
        60
        16.7%
        Minor
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        TPV_r_Q58E
        TPV/r
        PI
        3
        Q58E
        AccessoryNo
        15
        15.0
        60
        25.0%
        Significant
        Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance.
        TPV_r_V32I
        TPV/r
        PI
        3
        V32I
        MajorNo
        5
        5.0
        60
        8.3%
        Minor
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.

        PR Mutations

        Comprehensive listing of all mutations detected in the PR gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.

        Filterable table of detected protease mutations with positions, attributes, and special labels (SDRM, APOBEC, unusual variants).

        Showing 27/27 rows and 7/7 columns.
        MutationMutationPositionTypeSDRMAPOBECUnusualStructure
        DEMO_COMBO_NGS_A71V
        A71V
        71
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_C95V
        C95V
        95
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_D60E
        D60E
        60
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_E35G
        E35G
        35
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_G73S
        G73S
        73
        AccessoryYesNoNoSubstitution
        DEMO_COMBO_NGS_I13V
        I13V
        13
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I15V
        I15V
        15
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I47V
        I47V
        47
        MajorYesNoNoSubstitution
        DEMO_COMBO_NGS_I62V
        I62V
        62
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I93L
        I93L
        93
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_K20T
        K20T
        20
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_K70E
        K70E
        70
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L10R
        L10R
        10
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L19I
        L19I
        19
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L33F
        L33F
        33
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_L63P
        L63P
        63
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L89V
        L89V
        89
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_L90M
        L90M
        90
        MajorYesNoNoSubstitution
        DEMO_COMBO_NGS_M36I
        M36I
        36
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_N37T
        N37T
        37
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_P39PS
        P39PS
        39
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_Q58E
        Q58E
        58
        AccessoryNoNoNoSubstitution
        DEMO_COMBO_NGS_R41K
        R41K
        41
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V11L
        V11L
        11
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V32I
        V32I
        32
        MajorYesNoNoSubstitution
        DEMO_COMBO_NGS_V77I
        V77I
        77
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V82I
        V82I
        82
        OtherNoNoNoSubstitution

        PR Mutation Summary

        Summary of mutation types detected in the PR gene, including counts, percentages, and complete lists of mutations by type.

        Distribution of protease mutation types with counts, percentages, and representative examples, including SDRM and APOBEC-associated categories.

        Showing 4/4 rows and 4/4 columns.
        Mutation TypeCountPercentageMutationsClinical Implication
        Major
        3
        11.1%
        I47V, L90M, V32IDirect resistance to one or more drugs
        Accessory
        5
        18.5%
        G73S, K20T, L33F, L89V, Q58EEnhance resistance when present with major mutations
        SDRM
        4
        14.8%
        G73S, I47V, L90M, V32IUsed for surveillance of transmitted resistance
        Other
        19
        70.4%
        A71V, C95V, D60E, E35G, I13V, I15V, I62V, I93L, K70E, L10R, L19I, L63P, M36I, N37T, P39PS, R41K, V11L, V77I, V82IPolymorphisms or mutations with minimal impact on drug resistance

        PR Mutation Clinical Significance

        Consolidated analysis of PR mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.

        Clinical interpretation of protease mutations grouped by importance (Major, Accessory, Other), with evidence-based notes from the Stanford HIV Drug Resistance Database.

        Showing 9/9 rows and 6/7 columns.
        Mutation TypeTypeMutationSDRMAPOBECAffected DrugsMax ImpactClinical Implication
        Accessory_G73SAccessoryG73SYesNoIDV/r (PI) (15.0), NFV (PI) (15.0), SQV/r (PI) (15.0), ATV/r (PI) (10.0), ATV/r (PI) (10.0), and 6 more
        15
        G73S/T/C/A are common non-polymorphic accessory mutations selected primarily by most PIs. They are associated with minimally reduced susceptibility to each of the PIs.
        Accessory_K20TAccessoryK20TNoNoNFV (PI) (15.0), ATV/r (PI) (5.0), FPV/r (PI) (5.0), IDV/r (PI) (5.0), SQV/r (PI) (5.0)
        15
        K20T is a non-polymorphic accessory PI-selected mutation associated with reduced susceptibility to ATV and LPV.
        Accessory_L33FAccessoryL33FNoNoFPV/r (PI) (10.0), NFV (PI) (10.0), TPV/r (PI) (10.0), ATV/r (PI) (5.0), DRV/r (PI) (5.0), and 3 more
        10
        L33F is a relatively non-polymorphic accessory mutation selected by each of the PIs. In combination with other PI-resistance mutations, it is associated with reduced susceptibility to LPV, ATV, and DRV.
        Accessory_L89VAccessoryL89VNoNoFPV/r (PI) (10.0), NFV (PI) (10.0), DRV/r (PI) (5.0), DRV/r (PI) (5.0), FPV/r (PI) (5.0), and 4 more
        10
        L89V is a nonpolymorphic accessory mutation weakly selected by each of the PIs. It appears to be minimally associated with reduced PI susceptibility. L89T is an uncommon non-polymorphic PI-selected mutation selected primarily by ATV in subtype A6 viruses.
        Accessory_Q58EAccessoryQ58ENoNoTPV/r (PI) (15.0), NFV (PI) (10.0)
        15
        Q58E is a minimally polymorphic accessory mutation selected by each of the PIs except DRV. In combination with other PI-resistance mutations, it may contribute to low-level ATV resistance.
        Major_I47VMajorI47VYesNoFPV/r (PI) (35.0), TPV/r (PI) (30.0), NFV (PI) (20.0), IDV/r (PI) (15.0), LPV/r (PI) (15.0), and 8 more
        35
        I47V is a non-polymorphic PI-selected mutation associated with reduced susceptibility to LPV and DRV.
        Major_L90MMajorL90MYesNoNFV (PI) (60.0), SQV/r (PI) (45.0), IDV/r (PI) (30.0), ATV/r (PI) (20.0), FPV/r (PI) (20.0), and 6 more
        60
        L90M is a non-polymorphic PI-selected mutation that reduces susceptibility to ATV and to a lesser extent LPV.
        Major_V32IMajorV32IYesNoFPV/r (PI) (30.0), ATV/r (PI) (15.0), DRV/r (PI) (15.0), IDV/r (PI) (15.0), LPV/r (PI) (15.0), and 18 more
        30
        V32I is a non-polymorphic mutation selected by LPV, ATV, and DRV which is associated with reduced susceptibility to each of these PIs.
        Other_V11LOtherV11LNoNoDRV/r (PI) (5.0), FPV/r (PI) (5.0), IDV/r (PI) (5.0), LPV/r (PI) (5.0), NFV (PI) (5.0)
        5
        V11I/L are relatively non-polymorphic accessory mutation selected in persons receiving DRV. V11L is a nonpolymorphic PI-selected mutation associated with reduced in vitro DRV susceptibility when it occurs in combination with other PI-resistance mutations.

        PR Drug Resistance Profile

        Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for PR gene.

        Drug-level protease inhibitor resistance with quantitative scores, weighted clinical impact, and interpretation to support PI regimen selection.

        Showing 8/8 rows and 5/8 columns.
        DrugDrugClassScoreWeighted ScorePrioritySIRLevelInterpretation
        DEMO_COMBO_NGS_ATV_r
        ATV/r
        PI
        80
        80.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_DRV_r
        DRV/r
        PI
        50
        83.3
        5
        I
        4
        Intermediate Resistance
        DEMO_COMBO_NGS_FPV_r
        FPV/r
        PI
        145
        145.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_IDV_r
        IDV/r
        PI
        115
        115.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_LPV_r
        LPV/r
        PI
        65
        65.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_NFV
        NFV
        PI
        180
        180.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_SQV_r
        SQV/r
        PI
        80
        80.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_TPV_r
        TPV/r
        PI
        60
        60.0
        3
        R
        5
        High-Level Resistance

        PR Drug Class Overview

        Summary of drug resistance patterns by drug class for PR. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 1 high-priority drugs affected.

        Summary of protease inhibitor (PI) class resistance, including the proportion of affected drugs and resistance-level distribution across the class.

        Showing 1/1 rows and 13/13 columns.
        Drug ClassDrug ClassTotal DrugsResistant% ResistantWeighted ScoreHigh-PriorityMax ScoreStatusHighIntLowPotSus
        PR_PI
        PI
        8
        8
        100.0%
        101.0
        1
        180
        High-level resistance
        7
        1
        0
        0
        0

        RT Mutation Position Map

        Interactive visualization of mutations along the RT gene sequence, highlighting positions of major, accessory, and other mutations with surveillance drug resistance mutations (SDRMs) and APOBEC-mediated mutations specially marked.

        Interactive map of RT mutation positions to highlight recurrent sites and clinically relevant regions.

        RT Mutation Position Map

        This visualization shows 32 mutations detected in the RT gene (positions 1-258), including 0 major resistance mutations and 8 surveillance drug resistance mutations (SDRMs). Hover over colored positions for details.

        1-100
         
         
         
         
         
        6Position 6
        • E6K - Other
          Changed from E to K
        7Position 7
        • T7P - Other
          Changed from T to P
         
         
        10
         
         
         
         
         
         
         
         
         
        20
         
         
         
         
         
         
         
         
         
        30
         
         
         
         
        35Position 35
        • V35T - Other
          Changed from V to T
         
         
         
        39Position 39
        • T39A - Other
          Changed from T to A
        40
        41Position 41
        • M41L - NRTI (SDRM)
          Changed from M to L
         
         
         
         
         
         
         
         
        50
         
         
         
         
         
         
         
         
         
        60Position 60
        • V60I - Other
          Changed from V to I
         
         
         
         
         
         
        67Position 67
        • D67N - NRTI (SDRM)
          Changed from D to N
         
        69Position 69
        • T69D - NRTI (SDRM)
          Changed from T to D
        70
         
         
         
        74Position 74
        • L74I - NRTI (SDRM)
          Changed from L to I
         
         
         
         
         
        80
         
         
         
         
         
         
         
         
         
        90
         
         
         
        94Position 94
        • I94L - Other
          Changed from I to L
         
         
         
         
         
        100
        101-200
         
        102Position 102
        • K102L - Other
          Changed from K to L
        103Position 103
        • K103R - Other
          Changed from K to R
         
         
         
         
         
         
        110
         
         
         
         
         
         
         
         
         
        120
         
        122Position 122
        • K122E - Other
          Changed from K to E
        123Position 123
        • D123ND - Other
          Changed from D to DN
         
         
         
         
         
         
        130
         
         
         
         
        135Position 135
        • I135T - Other
          Changed from I to T
         
         
        138Position 138
        • E138Q - NNRTI
          Changed from E to Q
         
        140
         
        142Position 142
        • I142V - Other
          Changed from I to V
         
         
         
         
         
         
         
        150
         
         
         
         
         
         
         
         
         
        160
         
        162Position 162
        • S162D - Other
          Changed from S to D
         
         
         
         
         
         
         
        170
         
         
         
         
         
         
        177Position 177
        • D177N - Other
          Changed from D to N
         
        179Position 179
        • V179D - NNRTI
          Changed from V to D
        180
        181Position 181
        • Y181I - NNRTI (SDRM)
          Changed from Y to I
         
         
        184Position 184
        • M184V - NRTI (SDRM)
          Changed from M to V
         
         
         
         
         
        190Position 190
        • G190A - NNRTI (SDRM)
          Changed from G to A
         
         
         
         
         
         
        197Position 197
        • Q197E - Other
          Changed from Q to E
         
         
        200Position 200
        • T200A - Other
          Changed from T to A
        201-258
         
        202Position 202
        • I202V - Other
          Changed from I to V
         
        204Position 204
        • E204Q - Other
          Changed from E to Q
         
         
        207Position 207
        • Q207KE - Other
          Changed from Q to EK
         
         
        210
        211Position 211
        • R211A - Other
          Changed from R to A
         
         
         
        215Position 215
        • T215F - NRTI (SDRM)
          Changed from T to F
         
         
         
        219Position 219
        • K219H - Other
          Changed from K to H
        220
         
         
         
         
         
         
         
         
         
        230
         
         
         
         
         
         
         
         
         
        240
         
         
         
         
        245Position 245
        • V245K - Other
          Changed from V to K
         
         
         
         
        250
         
         
         
         
         
         
         
         
        Major Mutation (Directly confers resistance)
        Accessory Mutation (Enhances resistance)
        Other Mutation (Polymorphism or unknown effect)
        Surveillance Drug Resistance Mutation (SDRM)
        APOBEC-mediated mutation

        Mutation Distribution Summary

        Mutation TypeCountPercentage
        Major Mutations00.0%
        Accessory Mutations00.0%
        Other Mutations32100.0%
        SDRM Mutations825.0%
        Total Mutations32100.0%

        RT Mutation-Specific Resistance Contribution

        Detailed breakdown of how individual genetic mutations and mutation patterns contribute to overall drug resistance scores in RT, highlighting the relative impact of specific mutations on drug efficacy.

        Per-mutation contribution of RT variants to resistance scores for individual NRTI and NNRTI agents.

        Showing 62/62 rows and 10/12 columns.
        DrugDrugClassDrug PriorityMutationsTypeSDRMContributionWeightedTotal Score% of TotalImpact CategoryClinical Comment
        3TC_M184V
        3TC
        NRTI
        4
        M184V
        OtherNo
        60
        80.0
        60
        100.0%
        Dominant
        M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance.
        ABC_D67N
        ABC
        NRTI
        3
        D67N
        OtherNo
        5
        5.0
        75
        6.7%
        Minor
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        ABC_L74I
        ABC
        NRTI
        3
        L74I
        OtherNo
        15
        15.0
        75
        20.0%
        Minor
        L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility.
        ABC_M41L
        ABC
        NRTI
        3
        M41L
        OtherNo
        5
        5.0
        75
        6.7%
        Minor
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        ABC_M41L_+_D67N_+_T215F
        ABC
        NRTI
        3
        M41L + D67N + T215F
        OtherNo
        5
        5.0
        75
        6.7%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        ABC_M41L_+_M184V_+_T215F
        ABC
        NRTI
        3
        M41L + M184V + T215F
        OtherNo
        10
        10.0
        75
        13.3%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        ABC_M41L_+_T215F
        ABC
        NRTI
        3
        M41L + T215F
        OtherNo
        10
        10.0
        75
        13.3%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        ABC_M184V
        ABC
        NRTI
        3
        M184V
        OtherNo
        15
        15.0
        75
        20.0%
        Minor
        M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance.
        ABC_T215F
        ABC
        NRTI
        3
        T215F
        OtherNo
        10
        10.0
        75
        13.3%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        AZT_D67N
        AZT
        NRTI
        3
        D67N
        OtherNo
        15
        15.0
        95
        15.8%
        Minor
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        AZT_M41L
        AZT
        NRTI
        3
        M41L
        OtherNo
        15
        15.0
        95
        15.8%
        Minor
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        AZT_M41L_+_D67N_+_T215F
        AZT
        NRTI
        3
        M41L + D67N + T215F
        OtherNo
        5
        5.0
        95
        5.3%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        AZT_M41L_+_T215F
        AZT
        NRTI
        3
        M41L + T215F
        OtherNo
        10
        10.0
        95
        10.5%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        AZT_T215F
        AZT
        NRTI
        3
        T215F
        OtherNo
        60
        60.0
        95
        63.2%
        Major
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        D4T_D67N
        D4T
        NRTI
        3
        D67N
        OtherNo
        15
        15.0
        85
        17.6%
        Minor
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        D4T_M41L
        D4T
        NRTI
        3
        M41L
        OtherNo
        15
        15.0
        85
        17.6%
        Minor
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        D4T_M41L_+_D67N_+_T215F
        D4T
        NRTI
        3
        M41L + D67N + T215F
        OtherNo
        5
        5.0
        85
        5.9%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        D4T_M41L_+_T215F
        D4T
        NRTI
        3
        M41L + T215F
        OtherNo
        10
        10.0
        85
        11.8%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        D4T_T69D
        D4T
        NRTI
        3
        T69D
        OtherNo
        10
        10.0
        85
        11.8%
        Minor
        T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility.
        D4T_T215F
        D4T
        NRTI
        3
        T215F
        OtherNo
        40
        40.0
        85
        47.1%
        Significant
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        DDI_D67N
        DDI
        NRTI
        3
        D67N
        OtherNo
        5
        5.0
        145
        3.4%
        Minor
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        DDI_L74I
        DDI
        NRTI
        3
        L74I
        OtherNo
        60
        60.0
        145
        41.4%
        Significant
        L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility.
        DDI_M41L
        DDI
        NRTI
        3
        M41L
        OtherNo
        10
        10.0
        145
        6.9%
        Minor
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        DDI_M41L_+_D67N_+_T215F
        DDI
        NRTI
        3
        M41L + D67N + T215F
        OtherNo
        5
        5.0
        145
        3.4%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        DDI_M41L_+_T215F
        DDI
        NRTI
        3
        M41L + T215F
        OtherNo
        10
        10.0
        145
        6.9%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        DDI_M184V
        DDI
        NRTI
        3
        M184V
        OtherNo
        10
        10.0
        145
        6.9%
        Minor
        M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance.
        DDI_T69D
        DDI
        NRTI
        3
        T69D
        OtherNo
        30
        30.0
        145
        20.7%
        Minor
        T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility.
        DDI_T215F
        DDI
        NRTI
        3
        T215F
        OtherNo
        15
        15.0
        145
        10.3%
        Minor
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        DOR_Y181I
        DOR
        NNRTI
        3
        Y181I
        OtherNo
        10
        10.0
        20
        50.0%
        Major
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        DOR_Y181I_+_G190A
        DOR
        NNRTI
        3
        Y181I + G190A
        OtherNo
        10
        10.0
        20
        50.0%
        Major
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        DPV_E138Q
        DPV
        NNRTI
        3
        E138Q
        OtherNo
        20
        20.0
        105
        19.0%
        Minor
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        DPV_G190A
        DPV
        NNRTI
        3
        G190A
        OtherNo
        15
        15.0
        105
        14.3%
        Minor
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        DPV_V179D
        DPV
        NNRTI
        3
        V179D
        OtherNo
        10
        10.0
        105
        9.5%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        DPV_Y181I
        DPV
        NNRTI
        3
        Y181I
        OtherNo
        60
        60.0
        105
        57.1%
        Major
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        EFV_E138Q
        EFV
        NNRTI
        3
        E138Q
        OtherNo
        10
        10.0
        115
        8.7%
        Minor
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        EFV_G190A
        EFV
        NNRTI
        3
        G190A
        OtherNo
        45
        45.0
        115
        39.1%
        Significant
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        EFV_K103R_+_V179D
        EFV
        NNRTI
        3
        K103R + V179D
        OtherNo
        20
        20.0
        115
        17.4%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        EFV_V179D
        EFV
        NNRTI
        3
        V179D
        OtherNo
        10
        10.0
        115
        8.7%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        EFV_Y181I
        EFV
        NNRTI
        3
        Y181I
        OtherNo
        30
        30.0
        115
        26.1%
        Significant
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        ETR_E138Q
        ETR
        NNRTI
        3
        E138Q
        OtherNo
        10
        10.0
        100
        10.0%
        Minor
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        ETR_G190A
        ETR
        NNRTI
        3
        G190A
        OtherNo
        10
        10.0
        100
        10.0%
        Minor
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        ETR_V179D
        ETR
        NNRTI
        3
        V179D
        OtherNo
        10
        10.0
        100
        10.0%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        ETR_Y181I
        ETR
        NNRTI
        3
        Y181I
        OtherNo
        60
        60.0
        100
        60.0%
        Major
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        ETR_Y181I_+_G190A
        ETR
        NNRTI
        3
        Y181I + G190A
        OtherNo
        10
        10.0
        100
        10.0%
        Minor
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        FTC_M184V
        FTC
        NRTI
        4
        M184V
        OtherNo
        60
        80.0
        60
        100.0%
        Dominant
        M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance.
        NVP_E138Q
        NVP
        NNRTI
        3
        E138Q
        OtherNo
        10
        10.0
        160
        6.2%
        Minor
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        NVP_G190A
        NVP
        NNRTI
        3
        G190A
        OtherNo
        60
        60.0
        160
        37.5%
        Significant
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        NVP_K103R_+_V179D
        NVP
        NNRTI
        3
        K103R + V179D
        OtherNo
        20
        20.0
        160
        12.5%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        NVP_V179D
        NVP
        NNRTI
        3
        V179D
        OtherNo
        10
        10.0
        160
        6.2%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        NVP_Y181I
        NVP
        NNRTI
        3
        Y181I
        OtherNo
        60
        60.0
        160
        37.5%
        Significant
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        RPV_E138Q
        RPV
        NNRTI
        3
        E138Q
        OtherNo
        20
        20.0
        130
        15.4%
        Minor
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        RPV_G190A
        RPV
        NNRTI
        3
        G190A
        OtherNo
        15
        15.0
        130
        11.5%
        Minor
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        RPV_K103R_+_V179D
        RPV
        NNRTI
        3
        K103R + V179D
        OtherNo
        15
        15.0
        130
        11.5%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        RPV_V179D
        RPV
        NNRTI
        3
        V179D
        OtherNo
        10
        10.0
        130
        7.7%
        Minor
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        RPV_Y181I
        RPV
        NNRTI
        3
        Y181I
        OtherNo
        60
        60.0
        130
        46.2%
        Significant
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        RPV_Y181I_+_G190A
        RPV
        NNRTI
        3
        Y181I + G190A
        OtherNo
        10
        10.0
        130
        7.7%
        Minor
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        TDF_D67N
        TDF
        NRTI
        4
        D67N
        OtherNo
        5
        6.7
        30
        16.7%
        Minor (High-Priority Drug)
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        TDF_L74I
        TDF
        NRTI
        4
        L74I
        OtherNo
        5
        6.7
        30
        16.7%
        Minor (High-Priority Drug)
        L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility.
        TDF_M41L
        TDF
        NRTI
        4
        M41L
        OtherNo
        5
        6.7
        30
        16.7%
        Minor (High-Priority Drug)
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        TDF_M41L_+_D67N_+_T215F
        TDF
        NRTI
        4
        M41L + D67N + T215F
        OtherNo
        5
        6.7
        30
        16.7%
        Minor (High-Priority Drug)
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        TDF_M41L_+_T215F
        TDF
        NRTI
        4
        M41L + T215F
        OtherNo
        10
        13.3
        30
        33.3%
        Significant (High-Priority Drug)
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        TDF_T215F
        TDF
        NRTI
        4
        T215F
        OtherNo
        10
        13.3
        30
        33.3%
        Significant (High-Priority Drug)
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.

        RT Mutations

        Comprehensive listing of all mutations detected in the RT gene with their positions and properties. This table includes major resistance mutations, accessory mutations, surveillance drug resistance mutations (SDRMs), APOBEC-mediated mutations, and unusual mutations.

        Searchable inventory of reverse transcriptase mutations with genomic position, mutation properties, and special classifications.

        Showing 32/32 rows and 7/7 columns.
        MutationMutationPositionTypeSDRMAPOBECUnusualStructure
        DEMO_COMBO_NGS_D67N
        D67N
        67
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_D123ND
        D123ND
        123
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_D177N
        D177N
        177
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_E6K
        E6K
        6
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_E138Q
        E138Q
        138
        NNRTI
        NoNoNoSubstitution
        DEMO_COMBO_NGS_E204Q
        E204Q
        204
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_G190A
        G190A
        190
        NNRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_I94L
        I94L
        94
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I135T
        I135T
        135
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I142V
        I142V
        142
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_I202V
        I202V
        202
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_K102L
        K102L
        102
        OtherNoNoYesSubstitution
        DEMO_COMBO_NGS_K103R
        K103R
        103
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_K122E
        K122E
        122
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_K219H
        K219H
        219
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_L74I
        L74I
        74
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_M41L
        M41L
        41
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_M184V
        M184V
        184
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_Q197E
        Q197E
        197
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_Q207KE
        Q207KE
        207
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_R211A
        R211A
        211
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_S162D
        S162D
        162
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_T7P
        T7P
        7
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_T39A
        T39A
        39
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_T69D
        T69D
        69
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_T200A
        T200A
        200
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_T215F
        T215F
        215
        NRTI
        YesNoNoSubstitution
        DEMO_COMBO_NGS_V35T
        V35T
        35
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V60I
        V60I
        60
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_V179D
        V179D
        179
        NNRTI
        NoNoNoSubstitution
        DEMO_COMBO_NGS_V245K
        V245K
        245
        OtherNoNoNoSubstitution
        DEMO_COMBO_NGS_Y181I
        Y181I
        181
        NNRTI
        YesNoNoSubstitution

        RT Mutation Summary

        Summary of mutation types detected in the RT gene, including counts, percentages, and complete lists of mutations by type.

        Distribution of RT mutation types (Major, Accessory, polymorphic), including TAMs, NNRTI-associated, and APOBEC-associated patterns.

        Showing 3/3 rows and 4/4 columns.
        Mutation TypeCountPercentageMutationsClinical Implication
        SDRM
        8
        25.0%
        D67N, G190A, L74I, M184V, M41L, T215F, T69D, Y181IUsed for surveillance of transmitted resistance
        Unusual
        1
        3.1%
        K102LRarely observed in untreated patients
        Other
        32
        100.0%
        D123ND, D177N, D67N, E138Q, E204Q, E6K, G190A, I135T, I142V, I202V, I94L, K102L, K103R, K122E, K219H, L74I, M184V, M41L, Q197E, Q207KE, R211A, S162D, T200A, T215F, T39A, T69D, T7P, V179D, V245K, V35T, V60I, Y181IPolymorphisms or mutations with minimal impact on drug resistance

        RT Mutation Clinical Significance

        Consolidated analysis of RT mutations and their clinical implications for HIV drug resistance. This table groups information by mutation, showing affected drugs and their resistance scores, with detailed clinical commentary.

        Clinical interpretation of RT mutations, including effects on drug activity and viral fitness, with linked drug-specific context.

        Showing 11/11 rows and 6/7 columns.
        Mutation TypeTypeMutationSDRMAPOBECAffected DrugsMax ImpactClinical Implication
        NNRTI_E138QNNRTIE138QNoNoRPV (NNRTI) (20.0), DPV (NNRTI) (20.0), EFV (NNRTI) (10.0), ETR (NNRTI) (10.0), NVP (NNRTI) (10.0)
        20
        E138Q/G are non-polymorphic accessory mutations selected by ETR occasionally NVP and EFV. They cause low-level reductions in susceptibility to NVP, RPV, and ETR.
        NNRTI_G190ANNRTIG190AYesNoNVP (NNRTI) (60.0), EFV (NNRTI) (45.0), RPV (NNRTI) (15.0), DPV (NNRTI) (15.0), DOR (NNRTI) (10.0), and 3 more
        60
        G190A is a non-polymorphic mutation that causes high-level resistance to NVP and intermediate resistance to EFV. It does not significantly reduce susceptibility to RPV, ETR, or DOR.
        NNRTI_V179DNNRTIV179DNoNoEFV (NNRTI) (20.0), NVP (NNRTI) (20.0), RPV (NNRTI) (15.0), EFV (NNRTI) (10.0), ETR (NNRTI) (10.0), and 3 more
        20
        V179D/E are somewhat polymorphic accessory NNRTI-selected mutation. In combination with other NNRTI DRMs, they appear to contribute low-levels of reduced susceptibility to each of the NNRTIs. In particular, the combinations of K103R/V179D and V106I/V179D act synergistically to reduce NVP and EFV susceptibility.
        NNRTI_Y181INNRTIY181IYesNoETR (NNRTI) (60.0), NVP (NNRTI) (60.0), RPV (NNRTI) (60.0), DPV (NNRTI) (60.0), EFV (NNRTI) (30.0), and 4 more
        60
        Y181I/V are 2-base pair non-polymorphic mutations selected by NVP and ETR. They cause high-level resistance to NVP, ETR, and RPV but not EFV. Their effects on DOR have not been well-characterized.
        NRTI_D67NNRTID67NYesNoAZT (NRTI) (15.0), D4T (NRTI) (15.0), ABC (NRTI) (5.0), ABC (NRTI) (5.0), AZT (NRTI) (5.0), and 5 more
        15
        D67N is a non-polymorphic TAM associated with low-level resistance to AZT.
        NRTI_L74INRTIL74IYesNoDDI (NRTI) (60.0), ABC (NRTI) (15.0), TDF (NRTI) (5.0)
        60
        L74V causes intermediate ABC resistance. L74I causes low-level ABC resistance. L74V increases AZT, TFV, and islatravir susceptibility.
        NRTI_M41LNRTIM41LYesNoAZT (NRTI) (15.0), D4T (NRTI) (15.0), ABC (NRTI) (10.0), ABC (NRTI) (10.0), AZT (NRTI) (10.0), and 11 more
        15
        M41L is a TAM that usually occurs with T215Y. In combination, M41L plus T215Y confer intermediate / high-level resistance to AZT and contribute to reduced ABC and TDF susceptibility.
        NRTI_M184VNRTIM184VYesNoFTC (NRTI) (60.0), 3TC (NRTI) (60.0), ABC (NRTI) (15.0), ABC (NRTI) (10.0), DDI (NRTI) (10.0), and 3 more
        60
        M184V/I cause high-level in vitro resistance to 3TC and FTC and low/intermediate resistance to ABC (3-fold reduced susceptibility). M184V/I are not contraindications to continued treatment with 3TC or FTC because they increase susceptibility to AZT and TDF and are associated with clinically significant reductions in HIV-1 replication. M184V/I causes a 5-fold reduction in islatravir susceptibility of uncertain clinical significance.
        NRTI_T69DNRTIT69DYesNoDDI (NRTI) (30.0), D4T (NRTI) (10.0)
        30
        T69D is a nonpolymorphic mutation selected by early NRTIs that does not appear to reduce AZT, ABC, or TDF susceptibility.
        NRTI_T215FNRTIT215FYesNoAZT (NRTI) (60.0), D4T (NRTI) (40.0), DDI (NRTI) (15.0), ABC (NRTI) (10.0), ABC (NRTI) (10.0), and 11 more
        60
        T215Y/F are TAMs that causes intermediate/high-level resistance to AZT and potentially low-level resistance to ABC and TDF. The presence of ≥2 TAMs appears to reduce islatravir susceptibility but the impact of individual TAMs is not known.
        Other_K103ROtherK103RNoNoEFV (NNRTI) (20.0), NVP (NNRTI) (20.0), RPV (NNRTI) (15.0)
        20
        K103R is a polymorphic mutation that alone has no effect on NNRTI susceptibility. However, in combination with V179D, it reduces NVP and EFV susceptibility about 15-fold.

        RT Drug Resistance Profile

        Comprehensive analysis of antiretroviral drug susceptibility and resistance patterns based on genetic mutations, with quantitative resistance scores and clinical interpretations for RT gene.

        Drug-level RT susceptibility profile with standard and weighted scores for NRTIs and NNRTIs, aligned to clinical importance.

        Showing 13/13 rows and 5/8 columns.
        DrugDrugClassScoreWeighted ScorePrioritySIRLevelInterpretation
        DEMO_COMBO_NGS_3TC
        3TC
        NRTI
        60
        80.0
        4
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_ABC
        ABC
        NRTI
        75
        75.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_AZT
        AZT
        NRTI
        95
        95.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_D4T
        D4T
        NRTI
        85
        85.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_DDI
        DDI
        NRTI
        145
        145.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_DOR
        DOR
        NNRTI
        20
        20.0
        3
        I
        3
        Low-Level Resistance
        DEMO_COMBO_NGS_DPV
        DPV
        NNRTI
        105
        105.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_EFV
        EFV
        NNRTI
        115
        115.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_ETR
        ETR
        NNRTI
        100
        100.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_FTC
        FTC
        NRTI
        60
        80.0
        4
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_NVP
        NVP
        NNRTI
        160
        160.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_RPV
        RPV
        NNRTI
        130
        130.0
        3
        R
        5
        High-Level Resistance
        DEMO_COMBO_NGS_TDF
        TDF
        NRTI
        30
        40.0
        4
        I
        4
        Intermediate Resistance

        RT Drug Class Overview

        Summary of drug resistance patterns by drug class for RT. This table shows the proportion of drugs in each class with resistance, categorized by resistance level. Overall resistance: 100.0% of drugs show resistance, with 3 high-priority drugs affected.

        Summary of RT inhibitor resistance across NRTI and NNRTI classes, with class-level metrics and priority drug indicators.

        Showing 2/2 rows and 13/13 columns.
        Drug ClassDrug ClassTotal DrugsResistant% ResistantWeighted ScoreHigh-PriorityMax ScoreStatusHighIntLowPotSus
        RT_NNRTI
        NNRTI
        6
        6
        100.0%
        105.0
        0
        160
        High-level resistance
        5
        0
        1
        0
        0
        RT_NRTI
        NRTI
        7
        7
        100.0%
        85.7
        3
        145
        High-level resistance
        6
        1
        0
        0
        0